Designing multiple user perspectives and functionality for clinical decision support systems

Clinical Decision Support Systems (CDSSs) need to disseminate expertise in formats that suit different end users and with functionality tuned to the context of assessment. This paper reports research into a method for designing and implementing knowledge structures that facilitate the required flexibility. A psychological model of expertise is represented using a series of formally specified and linked XML trees that capture increasing elements of the model, starting with hierarchical structuring, incorporating reasoning with uncertainty, and ending with delivering the final CDSS. The method was applied to the Galatean Risk and Safety Tool, GRiST, which is a web-based clinical decision support system (www.egrist.org) for assessing mental-health risks. Results of its clinical implementation demonstrate that the method can produce a system that is able to deliver expertise targetted and formatted for specific patient groups, different clinical disciplines, and alternative assessment settings. The approach may be useful for developing other real-world systems using human expertise and is currently being applied to a logistics domain. © 2013 Polish Information Processing Society.

Linking comprehensive performance assessment to the balanced scorecard:evidence from Hertfordshire County Council

Over the course of the last twenty years there has been a growing academic interest in performance management, particularly in respect of the evolution of new techniques and their resulting impact. One important theoretical development has been the emergence of multidimensional performance measurement models that are potentially applicable within the public sector. Empirically, academic researchers are increasingly supporting the use of such models as a way of improving public sector management and the effectiveness of service provision (Mayston, 1985; Pollitt, 1986; Bates and Brignall, 1993; and Massey, 1999). This paper seeks to add to the literature by using both theoretical and empirical evidence to argue that CPA, the external inspection tool used by the Audit Commission to evaluate local authority performance management, is a version of the Balanced Scorecard which, when adapted for internal use, may have beneficial effects. After demonstrating the parallels between the CPA framework and Kaplan and Norton's public sector Balanced Scorecard (BSC), we use a case study of the BSC based performance management system in Hertfordshire County Council to demonstrate the empirical linkages between a local scorecard and CPA. We conclude that CPA is based upon the BSC and has the potential to serve as a springboard for the evolution of local authority performance management systems.

TQM in e-Learning: a Self-assessment Model and Questionnaire

Organizations are seeking new, integrated systems that enable rapid changes through early identification of opportunities and problems, tracking of progress against plans, flexible allocation of resources to achieve goals, and consistent operations. Total Quality Management (TQM) is an overall business strategy. It means that all activities of the company will be focused on satisfying all stakeholders of the company. TQM can be realised by using the EFQM model. The EFQM model is a tool that organizations may use as a framework for self-evaluation that enables an organization to identify its strengths and areas for improvement and the extent to which its operations and results are in line with the characteristics of an excellent organization. We focus on a training organisation or to the learning department of an organization. So we are limiting the EFQM model to the training /learning activities. We can apply EFQM perfect on the level of an activity (business line) of a company. We selected the main criteria for which the learner can play the role of assessor. So only three main criteria left: the enabling resources, the enabling processes and the (learning) results for the learner. We limited the last one to “learning results” based on the Kirkpatrick model.

Automated Assessment of Student Activity in Moodle

Report published in the Proceedings of the National Conference on "Education and Research in the Information Society", Plovdiv, May, 2014

Model and performance of a no-reference quality assessment metric for video streaming

Video streaming via Transmission Control Protocol (TCP) networks has become a popular and highly demanded service, but its quality assessment in both objective and subjective terms has not been properly addressed. In this paper, based on statistical analysis a full analytic model of a no-reference objective metric, namely pause intensity (PI), for video quality assessment is presented. The model characterizes the video playout buffer behavior in connection with the network performance (throughput) and the video playout rate. This allows for instant quality measurement and control without requiring a reference video. PI specifically addresses the need for assessing the quality issue in terms of the continuity in the playout of TCP streaming videos, which cannot be properly measured by other objective metrics such as peak signal-to-noise-ratio, structural similarity, and buffer underrun or pause frequency. The performance of the analytical model is rigidly verified by simulation results and subjective tests using a range of video clips. It is demonstrated that PI is closely correlated with viewers' opinion scores regardless of the vastly different composition of individual elements, such as pause duration and pause frequency which jointly constitute this new quality metric. It is also shown that the correlation performance of PI is consistent and content independent. © 2013 IEEE.

A new scheduling method for enhanced quality of experience in LTE systems

In this paper a new approach to the resource allocation and scheduling mechanism that reflects the effect of user's Quality of Experience is presented. The proposed scheduling algorithm is examined in the context of 3GPP Long Term Evolution (LTE) system. Pause Intensity (PI) as an objective and no-reference quality assessment metric is employed to represent user's satisfaction in the scheduler of eNodeB. PI is in fact a measurement of discontinuity in the service. The performance of the scheduling method proposed is compared with two extreme cases: maxCI and Round Robin scheduling schemes which correspond to the efficiency and fairness oriented mechanisms, respectively. Our work reveals that the proposed method is able to perform between fairness and efficiency requirements, in favor of higher satisfaction for the users to the desired level. © VDE VERLAG GMBH.

Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

A tudásmenedzsment és az IT audit kapcsolódási pontjai - a tudásmenedzsment-rendszerek auditja (Connection points of knowledge management and IT audit – audit of knowledge management systems)

A cikkben a szerzők megvizsgálják a tudásmenedzsment komplex rendszerfejlesztési projektekben és az informatikai auditban játszott szerepét. Fő céljuk, hogy a tudásmenedzsment-rendszerek fejlesztéséhez kapcsolódó audit támogatására értékelési modellt készítsenek. Cikkükben megvizsgálják a tudásmenedzsmentnek az IT-auditban játszott általános szerepét, az auditban érintett tudásvagyon védelmének kérdését, a tudásmenedzsment-folyamatok szerepét a rendszerfejlesztésben (auditszempontból), a kontrollok implementálását, valamint a tudásmenedzsment és az IT-audittal kapcsolatos szabványok, módszertanok kapcsolatát. Az eredmények illusztrálására egy az Európai Unió 7. keretprogramjából finanszírozott nemzetközi projekt (GUIDE, IST–2003–507498) szolgál. ________________ Authors investigate the role of knowledge management in complex system development projects and IT audit. The primary goal is to provide an evaluation framework for an assessment of the development of special knowledge management solutions. On the other hand IT audit itself is a knowledge-dependent activity. The paper analyses the role of knowledge management in IT audit in general, the protection of knowledge assets during an audit, the role of knowledge management processes during system development (from audit point of view) and in the implementation of controls, the relationship of knowledge management with audit standards. Authors investigate the specialities of KM developments from audit point of view (particularly important aspects of audit, specific control objectives) A case study, based on experiences gained from GUIDE project (IST-2003-507498 funded by the European Commission’s 6th Framework Programme) illustrates the findings.

A study of learners' perceived value and satisfaction for implied effectiveness of online learning systems

Online learning systems (OLS) have become center stage for corporations and educational institutions as a competitive tool in the knowledge economy. The satisfaction construct has received extensive coverage in information systems literature as an indicator of effectiveness but has been criticized for lack of validity; yet, the value construct has been largely ignored, although it has a long history in psychology, sociology, and behavioral science. The purpose of this dissertation is to investigate the value and satisfaction constructs in the context of OLS, and their perceived by learners relationship for implied effectiveness of OLS. ^ First, a qualitative phase is employed to gather OLS values from learners' focus groups, followed by a pilot phase to refine a proposed instrument, and a main phase to validate the survey. Responses were received from 75 students in four focus groups, 141 in the pilot, and 207 the main survey. Extensive data cleaning and exploratory factor analysis were done to identify factors of learners' perceived value and satisfaction of OLS. Then, Value-Satisfaction grids and the Learners' Value Index of Satisfaction (LeVIS) were developed as benchmarking tools of OLS. Moreover, Multicriteria Decision Analysis (MCDA) techniques were employed to impute value from satisfaction scores in order to reduce survey response time. ^ The results provided four satisfaction and four value factors with high reliability (Cronbach's α). Moreover, value and satisfaction were found to have low linear and nonlinear correlations, indicating that they are two distinct uncorrelated constructs. This is consistent with the literature. Value-Satisfaction grids and the LeVIS index indicated relatively high effectiveness for technology and support characteristics, relatively low effectiveness for professor's characteristics, while course and learner characteristics indicated average effectiveness. ^ The main contributions of this study include identifying, defining, and articulating the relationship between value and satisfaction constructs as assessment of users' implied IS effectiveness, as well as assessing the accuracy of MCDA procedures to predict value scores, thus reducing by half the survey questionnaire size. ^

Signal processing of physiological signals for automated assessment of stress in computer users

The need to provide computers with the ability to distinguish the affective state of their users is a major requirement for the practical implementation of affective computing concepts. This dissertation proposes the application of signal processing methods on physiological signals to extract from them features that can be processed by learning pattern recognition systems to provide cues about a person's affective state. In particular, combining physiological information sensed from a user's left hand in a non-invasive way with the pupil diameter information from an eye-tracking system may provide a computer with an awareness of its user's affective responses in the course of human-computer interactions. In this study an integrated hardware-software setup was developed to achieve automatic assessment of the affective status of a computer user. A computer-based "Paced Stroop Test" was designed as a stimulus to elicit emotional stress in the subject during the experiment. Four signals: the Galvanic Skin Response (GSR), the Blood Volume Pulse (BVP), the Skin Temperature (ST) and the Pupil Diameter (PD), were monitored and analyzed to differentiate affective states in the user. Several signal processing techniques were applied on the collected signals to extract their most relevant features. These features were analyzed with learning classification systems, to accomplish the affective state identification. Three learning algorithms: Naïve Bayes, Decision Tree and Support Vector Machine were applied to this identification process and their levels of classification accuracy were compared. The results achieved indicate that the physiological signals monitored do, in fact, have a strong correlation with the changes in the emotional states of the experimental subjects. These results also revealed that the inclusion of pupil diameter information significantly improved the performance of the emotion recognition system. ^

Water resources assessment and geographic information system (GIS)-based stormwater runoff estimates for artificial recharge of freshwater aquifers in New Providence, Bahamas

The Bahamas is a small island nation that is dealing with the problem of freshwater shortage. All of the country’s freshwater is contained in shallow lens aquifers that are recharged solely by rainfall. The country has been struggling to meet the water demands by employing a combination of over-pumping of aquifers, transport of water by barge between islands, and desalination of sea water. In recent decades, new development on New Providence, where the capital city of Nassau is located, has created a large area of impervious surfaces and thereby a substantial amount of runoff with the result that several of the aquifers are not being recharged. A geodatabase was assembled to assess and estimate the quantity of runoff from these impervious surfaces and potential recharge locations were identified using a combination of Geographic Information Systems (GIS) and remote sensing. This study showed that runoff from impervious surfaces in New Providence represents a large freshwater resource that could potentially be used to recharge the lens aquifers on New Providence.

A multi-method approach for the assessment of composite indices and rankings

There is growing popularity in the use of composite indices and rankings for cross-organizational benchmarking. However, little attention has been paid to alternative methods and procedures for the computation of these indices and how the use of such methods may impact the resulting indices and rankings. This dissertation developed an approach for assessing composite indices and rankings based on the integration of a number of methods for aggregation, data transformation and attribute weighting involved in their computation. The integrated model developed is based on the simulation of composite indices using methods and procedures proposed in the area of multi-criteria decision making (MCDM) and knowledge discovery in databases (KDD). The approach developed in this dissertation was automated through an IT artifact that was designed, developed and evaluated based on the framework and guidelines of the design science paradigm of information systems research. This artifact dynamically generates multiple versions of indices and rankings by considering different methodological scenarios according to user specified parameters. The computerized implementation was done in Visual Basic for Excel 2007. Using different performance measures, the artifact produces a number of excel outputs for the comparison and assessment of the indices and rankings. In order to evaluate the efficacy of the artifact and its underlying approach, a full empirical analysis was conducted using the World Bank's Doing Business database for the year 2010, which includes ten sub-indices (each corresponding to different areas of the business environment and regulation) for 183 countries. The output results, which were obtained using 115 methodological scenarios for the assessment of this index and its ten sub-indices, indicated that the variability of the component indicators considered in each case influenced the sensitivity of the rankings to the methodological choices. Overall, the results of our multi-method assessment were consistent with the World Bank rankings except in cases where the indices involved cost indicators measured in per capita income which yielded more sensitive results. Low income level countries exhibited more sensitivity in their rankings and less agreement between the benchmark rankings and our multi-method based rankings than higher income country groups.

An assessment of natural and human disturbance effects on Mexican ecosystems: current trends and research gaps

Mexico harbors more than 10% of the planet’s endemic species. However, the integrity and biodiversity of many ecosystems is experiencing rapid transformation under the influence of a wide array of human and natural disturbances. In order to disentangle the effects of human and natural disturbance regimes at different spatial and temporal scales, we selected six terrestrial (temperate montane forests, montane cloud forests, tropical rain forests, tropical semi-deciduous forests, tropical dry forests, and deserts) and four aquatic (coral reefs, mangrove forests, kelp forests and saline lakes) ecosystems. We used semiquantitative statistical methods to assess (1) the most important agents of disturbance affecting the ecosystems, (2) the vulnerability of each ecosystem to anthropogenic and natural disturbance, and (3) the differences in ecosystem disturbance regimes and their resilience. Our analysis indicates a significant variation in ecological responses, recovery capacity, and resilience among ecosystems. The constant and widespread presence of human impacts on both terrestrial and aquatic ecosystems is reflected either in reduced area coverage for most systems, or reduced productivity and biodiversity, particularly in the case of fragile ecosystems (e.g., rain forests, coral reefs). In all cases, the interaction between historical human impacts and episodic high intensity natural disturbance (e.g., hurricanes, fires) has triggered a reduction in species diversity and induced significant changes in habitat distribution or species dominance. The lack of monitoring programs assessing before/after effects of major disturbances in Mexico is one of the major limitations to quantifying the commonalities and differences of disturbance effects on ecosystem properties.

Sediment and soil organic matter source assessment as revealed by the molecular distribution and carbon isotopic composition of n-alkanes

The assessment of organic matter (OM) sources in sediments and soils is a key to better understand the biogeochemical cycling of carbon in aquatic environments. While traditional molecular marker-based methods have provided such information for typical two end member (allochthonous/terrestrial vs. autochthonous/microbial)-dominated systems, more detailed, biomass-specific assessments are needed for ecosystems with complex OM inputs such as tropical and sub-tropical wetlands and estuaries where aquatic macrophytes and macroalgae may play an important role as OM sources. The aim of this study was to assess the utility of a combined approach using compound specific stable carbon isotope analysis and an n-alkane based proxy (Paq) to differentiate submerged and emergent/terrestrial vegetation OM inputs to soils/sediments from a sub-tropical wetland and estuarine system, the Florida Coastal Everglades. Results show that Paq values (0.13–0.51) for the emergent/terrestrial plants were generally lower than those for freshwater/marine submerged vegetation (0.45–1.00) and that compound specific δ13C values for the n-alkanes (C23 to C31) were distinctively different for terrestrial/emergent and freshwater/marine submerged plants. While crossplots of the Paq and n-alkane stable isotope values for the C23n-alkane suggest that OM inputs are controlled by vegetation changes along the freshwater to marine transect, further resolution regarding OM input changes along this landscape was obtained through principal component analysis (PCA), successfully grouping the study sites according to the OM source strengths. The data show the potential for this n-alkane based multi-proxy approach as a means of assessing OM inputs to complex ecosystems.

Assessment of natural resource conditions in and adjacent to Biscayne National Park. Natural Resource Report NPS/BISC/NRR—2012/598

This report is an assessment of the conditions of natural resources in Biscayne National Park (BNP) based on the compilation, review and evaluation of existing information on the Park’s natural resources. This review evaluates threats and stressors, and is intended to improve understanding of BNP resources to help guide Park management to address the identified threats, which are supported by enhanced data collection, research and assessment efforts. The report is focused on broad resource components, namely terrestrial resources and aquatic systems including: wetlands, canals, bay waters, marine/reef areas and ground waters. Biotic and abiotic resource components are considered in the review.